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目的研究以胸痛就诊肺血栓栓塞(PTE)患者临床特点,希望对降低肺血栓栓塞患者的死亡率提供帮助。方法选取南阳市中心医院院2008年1月—2009年12月就诊的晕厥患者856例作为观察对象,按照核素肺通气灌注显像检查结果将观察对象分为PTE组和非PTE组。按照胸痛发生原因,将非PE组患者分为心血管性胸痛、肺源性胸痛、胃肠源性胸痛、骨骼肌肉源性胸痛、带状疱疹性胸痛。分析PTE患者与非PTE患者性别、年龄、既往病史、其他伴随症状、体征的差别。结果胸痛患者中,10.2%的患者为PTE所至晕厥;各组患者性别构成、年龄均无显著性差异,PTE组具有3个以上静脉血栓危险因素的患者明显高于其他组;PTE组患者既往单下肢肿胀、气短、咯血、下肢腓肠肌压痛的发生率高于其他各组。结论以胸痛就诊的PTE患者常合并有多个静脉血栓的危险因素,其既往下肢肿胀的发生率高,常合并气短、咯血及腓肠肌挤压痛阳性。
Objective To study the clinical features of patients with pulmonary thromboembolism (PTE) treated with chest pain and hope to help reduce the mortality of patients with pulmonary thromboembolism. Methods A total of 856 syncope patients from January 2008 to December 2009 in Nanyang Central Hospital were selected as observation objects and divided into PTE group and non-PTE group according to nuclide pulmonary ventilation perfusion imaging results. According to the causes of chest pain, non-PE patients were divided into cardiovascular chest pain, pulmonary chest pain, gastrointestinal chest pain, skeletal muscle-derived chest pain, herpes zoster chest pain. Analysis of PTE patients with non-PTE patients gender, age, past medical history, other accompanying symptoms, signs of difference. Results Among the patients with chest pain, 10.2% had syncope as a result of PTE. There was no significant difference in sex composition and age between the two groups. Patients with PTE more than 3 risk factors for venous thrombosis were significantly higher than those in other groups. Single lower limb swelling, shortness of breath, hemoptysis, lower extremity gastrocnemius tenderness the incidence of higher than the other groups. Conclusions PTE patients treated with chest pain are often associated with multiple risk factors for venous thrombosis. The incidence of previous lower extremity swelling is high, often accompanied by shortness of breath, hemoptysis and tenderness of the gastrocnemius muscle.